Should I Remove My Baby’s Pacifier While They’re Sleeping?

When your baby arrives, you'll probably become laser-focused on their sleep safety, so it's natural to wonder if you should remove the pacifier from their mouth as they're snoozing. Concerns over sudden infant death syndrome (SIDS) may have become top of mind for you—and there are so many sleep guidelines, it can be hard to keep them straight.

We spoke to child health experts about whether or not you should allow your baby to sleep with their pacifier, so you can all hopefully catch a few winks and wake up rested.

Is It Safe to Sleep With a Pacifier?

Parents might be concerned that sleeping with a pacifier can cause SIDS, which is often related to an unsafe sleep environment, says the American Academy of Pediatrics (AAP). But experts agree that pacifiers may actually reduce the risk of SIDS.

Jenelle Ferry, MD, neonatologist and director of feeding, nutrition, and infant development at Pediatrix Neonatology of Florida, concurs with the AAP guidance. "It is safe, and use of a pacifier can be part of a safe sleep plan. The mechanism of action is unclear, but the use of pacifiers has been shown to reduce the risk of sudden unexplained death in infants," Dr. Ferry explains.

Indeed, meta-analyses show that the risk of SIDS is significantly lowered when a pacifier is introduced and used safely to soothe infants while they sleep—both for naps and nighttime. This news might be comforting for parents whose child has just fallen asleep with their pacifier, potentially after hours of struggling for shut-eye.

One caveat is that the pacifier should not be attached to them in any way to prevent strangulation hazards. "For safety, make sure the pacifier is not tied to the neck or hand," confirms Preeti Parikh, MD, pediatrician and Executive Medical Director at GoodRX.

Additionally, Shannon Tripp, RN, BSN, explains that a pacifier should be sized correctly for your child to prevent potential suffocation risk. "It is safe for a baby to sleep with a pacifier as long as the pacifier is the proper size for them. Generally speaking, the pacifier should grow with your baby," she explains.

In summary, if parents are using the proper pacifier for their child's age and it's in no way attached to their child, pacifiers are safe and even recommended for overnight use.

Pros and Cons of Sleeping With a Pacifier

Aside from the obvious advantage of SIDS reduction in infants, pacifiers also come with a host of other benefits. "A pacifier can improve their airflow and prevent acid reflux, which can reduce their risk for sudden infant death syndrome. Pacifiers can also provide comfort to your baby and help them sleep more soundly through the night," Dr. Parikh explains.

Providing your child with a comfort object can help greatly as you move through your sleep journey with them, especially if you plan on sleep training. Parents of premature babies can also reap the benefits of pacifier use. "In a preterm infant, the use of a pacifier may decrease length of hospitalization," Dr. Ferry says.

However, all that comfort comes with a few cons, so parents should remain vigilant. Babies who become reliant on a pacifier for sleeping may wake up or cry when it falls out. "If [the pacifier] falls out or is dropped in the middle of the night, they may wake and cry as they are learning the skills to fall asleep without it," Tripp explains.

Additionally, pacifiers may lead to dental problems or dental problems if used past the age of 2, experts explain. It's best to speak to your child's pediatrician if you feel they're growing too reliant on their pacifier.

Tips for Sleeping With a Pacifier

Keep reading for expert tips on allowing an infant to sleep with a pacifier.

• Choose pacifiers that encourage good bite and latch, based on your child's age
• Make sure your pacifiers are one piece to avoid choking hazards
• Consider pacifiers with air holes for easy breathing
• Don't clip a pacifier to your baby's clothing, a string, or bedding
• Clean, disinfect, and replace pacifiers regularly
• If your baby falls asleep and the pacifier falls out, but they remain asleep, there's no need to reinsert and risk a wake-up
  

Additionally, the AAP has a set of useful pacifier safety guidelines for parents of infants; you can find it here.

When Should Babies Stop Sleeping With a Pacifier?

Like many parenting choices, deciding when to quit pacifiers is nuanced and complicated. However, experts seem to agree that weaning around age 1 prevents ear infections and dental problems in children.

Indeed, the AAP and the The American Academy of Family Physicians recommend weaning "in the second six months of life." Attempts at weaning before 12 months may take less time than weaning later, "as continued habits become more difficult to break," Dr. Ferry explains.

Dr. Parikh agrees with the guidelines set by the AAP as well as her colleague's suggestion. "I prefer patients to start weaning by age 1, or a little before. At this point it is easier to wean them off it and the risk of SIDS decreases significantly by age 1."

But not all babies are made the same way, and some may prefer using their pacifier for longer. Weaning a pacifier may be easiest before 12 months, but for those who want it longer, Tripp recommends between 2 and 4 years old (but speak with a pediatrician or healthcare provider first).

Parents of preemie babies or those who experience frequent ear infections should also speak to their children's pediatrician for advice.

A Word From Verywell

Like every other parenting choice, pacifier use is nuanced and requires thought. But parents can take comfort knowing that sleeping with pacifiers is not only safe, but also recommended by experts. Babies snoozing with pacifiers in safe sleep environments may continue doing so, and their parents can rest easy.